Development of a Heart Transplant Readiness Scale for Waiting-List Adults: A Mixed-Methods Study Protocol

Background Heart transplantation (HT) outcomes are greatly affected by psychological, social, behavioral, and self-care aspects. But still, there is no suitable instrument available for measuring readiness of HT among adult waiting-list patients, especially in the case of Iran. Objective To develop and validate the Heart Transplantation Readiness Scale for Adult Patients on the Waiting List (HTRW-A). Methods This exploratory sequential mixed-methods research consists of two phases at five cardiac centers in Tehran, Iran. In Phase 1 (qualitative), semi-structured interviews will be conducted with the participants including HT candidates, HT recipients, family members, nursing staff, medical doctors, transplant coordinators, and managers (estimated n=20-30). The qualitative data will be analyzed using the conventional content analysis method to find out the concept and dimensions of HT readiness. In Phase 2 (quantitative), the qualitative findings will be used to generate the items. Psychometric properties will be assessed based on numerous stated evaluations; these will include: face validity, content validity (CVR, CVI), construct validity (exploratory factor analysis), convergent validity (using SIPAT) and also Cronbach’s alpha to measure internal consistency, and ICC to evaluate test-retest reliability using data collected from approximately 250 to 300 patients who are placed on a waiting list for HT. Expected Outcomes The HTRW-A is intended to serve as a valid, reliable, and culturally sensitive method of obtaining the multidimensionality of one’s readiness for HT. By identifying areas where a patient may be lacking in their preparedness for the transplant process, healthcare providers can better offer specific interventions prior to a transplant.